Cardiac enzymes: Difference between revisions

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== Markers ==
==Types==
{{Cardiac enzyme timecourse chart}}
{{Cardiac enzyme timecourse chart}}
<br>
*n I - 2-4 hrs 1st detect
**8-12 hrs w/100% sensitivity
**10-24 peak
**5-10 day duration
*Tn T - above plus 5-14 d duration
**CK-MB&nbsp;: 3-4
**8-12 (100% sensitive)
**10-24 hr peak&lt;/font&gt;&lt;/font&gt;&lt;/span&gt;
*MYOGLOBIN&nbsp;: 1-2 hrs detect first
**4-8 100% sens
**4-8 peak
**0.5-1.0 duration
**2-4 day duration&lt;/font&gt;&lt;/font&gt;&lt;/span&gt;


==Creatine Phosphokinase==
==Creatine Phosphokinase==
*can be elevated in trauma, rhabdo, hyperthermia, physical activity, renal or endocrine dz, systemic infections
*Can be elevated in trauma, [[rhabdomyolysis]], hyperthermia, physical activity, renal or endocrine disease, systemic infections
*if pt small with small muscle mass to begin with, total ck may not be elevated- so better to use ck index- is ratio of ckmb/ total ck. Elevated if > 3- 5%.
*If patient small with small muscle mass to begin with, total ck may not be elevated- so better to use CK index- is ratio of CKMB/ total CK. Elevated if > 3- 5%.
*CK Mass: with monoclonal antibody techniques, can directly measure ck mb mass as mmcg/L. More sensitive for detection of ami
*CK Mass: with monoclonal antibody techniques, can directly measure ck mb mass as mmcg/L. More sensitive for detection of AMI
*CK-MB can be removed from the routine ED cardiac panel without adversely affecting patient care<ref>Le RD, Kosowsky JM, Landman AB, et al. Clinical and financial impact of removing creatine kinase-MB from the routine testing menu in the emergency setting. Am J Emerg Med. 2015;33(1):72–5. </ref>


==See Also==
==See Also==
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*[[Acute Coronary Syndrome (Main)]]
*[[Acute Coronary Syndrome (Main)]]


[[Category:Cards]]
==References==
<references/>
 
[[Category:Cardiology]]

Latest revision as of 18:06, 27 October 2016

Types

Cardiac Enzymes Over Time

Type Interval (hours) Peak Elevation (hours) Return to Normal
Myoglobin 1-4 6-7 18-24 hours
Troponin I 3-12 10-24 3-10 days
Troponin T 3-12 10-24 5-14 days
CK-MB 4-12 12-24 2-3 days
LDH 8-12 24-48 10-14 days

Creatine Phosphokinase

  • Can be elevated in trauma, rhabdomyolysis, hyperthermia, physical activity, renal or endocrine disease, systemic infections
  • If patient small with small muscle mass to begin with, total ck may not be elevated- so better to use CK index- is ratio of CKMB/ total CK. Elevated if > 3- 5%.
  • CK Mass: with monoclonal antibody techniques, can directly measure ck mb mass as mmcg/L. More sensitive for detection of AMI
  • CK-MB can be removed from the routine ED cardiac panel without adversely affecting patient care[1]

See Also

References

  1. Le RD, Kosowsky JM, Landman AB, et al. Clinical and financial impact of removing creatine kinase-MB from the routine testing menu in the emergency setting. Am J Emerg Med. 2015;33(1):72–5.